Lesser metatarsophalangeal joint (MPJ) pathology is one of the most common conditions affecting the forefoot. Most commonly located at the second MPJ, progressive subluxation and dislocation of the phalangeal base on the metatarsal head primarily results from the disruption of the plantar plate, which often begins as predislocation syndrome.1 Painful dislocation of the toe in the dorsal plane, and less commonly in the medial or lateral planes, causes pain with ambulation and shoegear. Anatomic studies have demonstrated the importance of the plantar plate in stabilization of the MPJ in the sagittal plane.2,3
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Given that gunshot wounds reportedly affect the foot nearly five percent of the time, these authors provide an overview of ballistics associated with gunshot wounds as well as keys to injury assessment, surgical debridement and wound stabilization.
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